Journal of Qualitative Research in Health Sciences
Volume:6 Issue: 2, 2017

In year 1995, new hospital administration plan system (fee for service) was notified. Under the scheme, a dedicated percentage of specific revenues allocated as a fee for the hospital staff. In the early September 2014, new guidelines as performance-based fee for service plan with the aim to fix the deficiencies in the previous plan was reviewed and implemented in hospitals in Isfahan, Iran. This study aimed to investigate strategies for economic reforms to promote performance monitoring and improve infrastructure for implementation of the new fee for service guidelines in 2014.
In this qualitative study, in-depth interviews were used to collect the data. Eleven samples consisting of middle managers and senior headquarters of university hospitals, and some faculty members and hospital officials were chosen via purposive sampling method. All interviews were recorded and then written on paper. The duration of interviews varied between 30 to 60 minutes. Data analysis in this research was based on content analysis.
In this study, six main themes of strategies for economic reforms to promote performance monitoring and improve infrastructure for implementation of the new fee for service guidelines were obtained including payment system reform, price reform, defined package of services in public hospitals, financial and economic policies, reform and implementation of family physician referral system, and support of the insurers.
Our results define strategies for economic reforms to promote performance monitoring and improve infrastructure for implementation of the new fee for service guidelines. The most notable findings include pay reform, price reform, and financial and economic policies. These findings can help policy makers to consider the proposed revisions with appropriate strategies to monitor and improve the implementation of new fee for service plan.

Adolescents have unique developmental requirements and medical needs which make them different from adults and children. In addition, they have problems of different natures, but they receive health services from common service. The aim of this study was to describe the hospitalization experience in adolescents.
Using qualitative method, in-depth semi-structured interviews were conducted with a purposeful sample of 9 adolescents between the ages of 10 and 19 years, who were hospitalized in Zabol hospital pediatric ward, Zabol City, Iran. The data were analyzed based on Colaizzi's method. Rigors of the study were achieved by paying attention to four criteria: real value, applicability, consistency, and factuality.
Adolescent's experience of hospitalization was constructed by four main concepts concluding separation from family and friends, staying on an unfamiliar environment, fears of treatment, and limitation of individual autonomy.
Adolescents mostly are afraid of anonymous routines, procedures, and hospital personnel. Before the hospitalization of adolescents, there should be preparation plans for them; they often look for discipline and security in an unfamiliar environment. Therefore, hospital should be a safe place; so that, the adolescents` anxiety and worries can be reduced on the way from home to the hospital. It is suggested that professional staff view the design and routines of the ward from the perspective of adolescents; also it is better to perform adolescent-centered activities.

Becoming a mother in the neonatal intensive care unit is very different from becoming a mother of a full term infant in normal conditions. This study was conducted to explore factors affecting maternal role adaptation in mothers of preterm infants hospitalized in neonatal intensive care unit (NICU).
This study was a qualitative research. Participants were mothers of preterm infants hospitalized in neonatal intensive care unit of social security hospitals and hospitals affiliated to Kermanshah University of Medical Sciences located in Kermanshah City, Iran. Sampling method was purposive and data collection was through individual and semi-structured interviews. Data saturation was achieved after 17 interviews with mothers of preterm infants (under 36 weeks) who had history of hospitalization for at least one week in the NICU. Data was analyzed through conventional content analysis. In order to verify the trustworthiness of research data, credibility, transferability, conformability, and dependability were assessed.
Two main categories were explored in this study; individual factors which included three subcategories of emotional chaos, self-efficacy, and alienation; and social factors which included three subcategories of interaction, social support, and other’s judgment.
By providing different kinds of supports, prevention of other’s judgment, and promote mother's self-efficacy can empower mothers against problems and negative emotions and promote maternal role adaptation.

Intimacy is a kind of communication in which people need to have mutual trust and emotional closeness, and be able to detect each other's thoughts and feelings. Nurses need to establish a meaningful relationship with the child and his/her family. This study aimed to explain the quality of intimacy between nurses and patients in pediatric ward.
This phenomenological study was done in two university medical centers affiliated to Mazandaran and Golestan universities of medical sciences in Iran during the year 2016. 12 nurses were chosen in pediatric wards via purposive sampling method. To collect the data, semi-structured interviews were performed with at least one common question "When I say intimacy with the patient, what comes to your mind? Tell me about it"; probing questions such as why, how, and for example, frequently were used to deepen interviews. Interviews were recorded and transcribed immediately, and then were analyzed using a 7-step Collaizzi method.
A central theme of "intimacy as the key of successful relationship" with three subthemes "interaction for patient education", "interaction for qualified care", and "care for humanitarian interaction" were extracted.
Nurse's perception of intimacy with the patient and his/her family was nothing but professional communication for qualified care. Using the art of intimacy, nurses interact with patients and make a bridge to educate, take care, follow up, and treat the patient and family based on humanitarian behaviors.

The majority of mother deaths due to pregnancy and childbirth complications are unexpected. This occurrence will have several effects on family and create difficulties in their lives. The aim of this study was to describe and explain families’ experiences of maternal death due to pregnancy-related complications.
In this descriptive qualitative phenomenological research, the sample consisted of a total of 16 people, 10 members of families with at least one living child, experienced mother's death more than six months before, 3 supervisors of orphaned infants, and 3 midwives, selected via purposive sampling method. Data collection was performed using semi-structured interviews with open-ended questions. The mean duration of interviews was 45 minutes and an electronically tape recorder was used to record the interviews. Analysis of collected data was conducted using Colaizzi method via MAX-QD10 software.
3 major themes and 11 subthemes were extracted. The main themes were "spiritual and behavioral area", "lifestyle and fate changes", and "areas of social life". The integration of these themes resulted in an unequivocal statement that maternal mortality due to pregnancy and delivery complications was a tragedy which caused vulnerability of families, especially the children.
Familie's experiences of mothers’ death due to pregnancy-related complications were different from other mother's deaths regarding two aspects. First, maternal deaths could not been anticipated and were not expected. This lack of preparation exacerbated the vulnerability of the family. Second, the infant who strongly needed to be under mother’s care, remained uncertain. So, primary cares should be taken to prevent maternal mortality. In addition, governmental and non-governmental organizations should coordinate policies and specific cares to support the families and prevent early and late adverse effects.

Happiness is the amount of positive value that a person considers it for him/herself. Happiness is the common goal of all human beings; so that all human efforts will be done to get it, and it has changed to an important issue in human life at recent decades. Present study aimed to assess student's experiences of happiness phenomenon in Iran University of Medical Sciences, Iran.
This qualitative study was done in 2015 using phenomenological method. The number of participants was 12; the data were collected through semi-structured interviews, and analyzed using Colaizzi 7-step technique.
After considering and analyzing the data, 219 themes, 10 subthemes, and 3 main themes were extracted. The main categories included "goals achievement", "social ties", and "the ravages of life". Participants gained happiness through the process of social life and meanwhile declared basic individual efforts to achieve desires and happiness. They also suffered from some ravages and life destructive changes such as inappropriate welfare status, and encountered uncertain future.
Considering particular importance of social aspect of gaining happiness, and the effect of welfare status on it, preparing appropriate educational policy for students and planning to improve their economic conditions to increase happiness are of great importance.

Considering the importance of knowledge sharing in recent years and the nurse's need to act based on research in order to use their findings, experiences, and information for conscious decision making in clinical practices and in interaction with others, this study aimed to identify barriers to knowledge sharing among nurses in order to examine the challenges facing it.
This qualitative study was conducted using semi-structured interviews with 21 nurses in educational hospitals of Kerman City, Iran. All the interviews were recorded and then transcribed line by line and finally analyzed using Colaizzi method.
The barriers were identified in six main categories including "culture", "financial facilities", "politics, rules and regulations", "communications", "human resources", and "management process".
Effective knowledge sharing among nurses with the aim of increasing knowledge level and enhancing their services in the hospitals is essential. In addition, it is necessary to use strategies to face challenges and this requires management and policymaking more than before.

Given the common work scope of nurses and physicians, and the complementarity of the two professions, professional communication is inevitable. Effective communication between physicians and nurses is shown to enhance patient care and increase professional successfully and satisfaction. This study aimed to assess nurse's and physician's experiences of the pattern of their professional relationship with each other.
This was a qualitative research using phenomenological method. 15 semi-structured interviews were carried out with 8 nurses and 7 physicians. They described their experiences related to professional communication. The interviews were recorded and transcribed and the data were then analyzed using Colaizzi analysis method.
317 codes, 4 themes, and 19 subthemes which influenced the nurse-physician relationship were emerged from data analysis. One of the main themes was perception of the relationship pattern. Professional relationships between physicians and nurses were described based on this theme.
Based on the experience lived by nurses and physicians, to understand the professional relationship, perception of the relationship pattern should be known. It is an exponential relationship that improves the quality of patient care and nurse's and physician's job satisfaction. Nurse-physician professional relationship improves via cooperation, interaction, and dealing, and threatens by authoritarian and relationship, lack of cooperation and interaction, and scapegoating.

According to challenges and barriers facing developing countries because of weakness in organizing researches, academic education, and industrial sectors in these countries, the aim of the present study was to explain barriers existing in interaction between industry and universities of medical sciences in Iran.
This qualitative study was carried out based on content analysis method. 20 teachers from School of Health, Kerman University of Medical Sciences, Iran, selected via purposive sampling method, contributed in this study. Data was gathered through deep unstructured interviews. Every single interview was reviewed for several times to recognize semantic units and after that, encoding was done. Categorizing and summarizing codes also were done based on similarities. Data analysis was carried out contrastively and continuously at the same time with data gathering.
Based on contributors’ understanding of studied dimensions and their experiences, three main themes were recognized in terms of challenges and barriers in interaction between industry and university, "individual barriers", "organizational barriers", and "environmental barriers". Individual barriers were categorized by 4 subcategories, "attitude barriers", "skill barriers", "psychological barriers", and "demographic barriers". Organizational barriers were divided into 4 subcategories as "cultural", "managerial", "financial", and "structural" barriers. Finally, environmental barriers were categorized into 3 subcategories as "legal barriers", "special industrial features", and "supervisory barriers".
Based on the teachers’ experiences, "attitude barriers" are the most frequent cases of individual barriers, "financial barriers" are the most frequent cases of organizational barriers, and "legal barriers" are the most frequent cases of environmental barriers. Contributors confirmed that precise and proper planning originated from government good governance will result in forming a positive interaction between the two sectors.